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LETTER TO EDITOR
Year : 2018  |  Volume : 9  |  Issue : 1  |  Page : 48-49

Inconsolable cry: It may be insect bite


Department of Paediatrics, Aminu Kano Teaching Hospital/Bayero University, Kano, Nigeria

Date of Web Publication24-Jan-2018

Correspondence Address:
Dr. Ibrahim Aliyu
Department of Paediatrics, Aminu Kano Teaching Hospital/Bayero University, Kano
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjmsr.mjmsr_47_17

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How to cite this article:
Aliyu I. Inconsolable cry: It may be insect bite. Muller J Med Sci Res 2018;9:48-9

How to cite this URL:
Aliyu I. Inconsolable cry: It may be insect bite. Muller J Med Sci Res [serial online] 2018 [cited 2022 Jun 25];9:48-9. Available from: https://www.mjmsr.net/text.asp?2018/9/1/48/223915

Dear Editor,

Crying is a physiologic process which is a mode of communication and parents' overtime may understand the clue such as a child in distressed.[1] Furthermore, Brazelton [2] reported that crying may help an infant regain nervous homeostasis from overstimulation. The estimated incidence of excessive crying in children is estimated to range from 1.5% to 46%; this is attributed to the varied definition of excessive crying by various researches.[3]

While crying has the advantage of drawing the attention of the caregiver/parent to a child in distress, at times, it may be difficult deciphering the cause of crying in infants, especially when organic causes are not identifiable, this also becomes distressing to the caregiver/parents, especially when it become inconsolable, recurrent, and persistent as witnessed in infants with colic or better termed period of purple crying;[4] for its association with maternal depression have been reported.[4]

Three crying patterns have been described in infants: The basic cry, which is characterized by repeated periods of crying interrupted by brief periods of silence and usually of low pitch. Then the anger cry, which is more forceful, longer-lasting, and louder than the basic cry. Finally, the pain cry occurs suddenly without warning, and it is much distressing and explosive than the anger cry. Despite this classification, there is significant overlap; therefore, researches aimed at distinguishing common causes of distress in infants based on acoustic tone generated from crying had not been completely successful.[5] Common causes of crying include exposure to cold, hunger, and pain; insect bites may be associated with painful, itchy skin reactions, others may respond with significant skin swelling or anaphylactic reaction;[6] however, association with isolated uncontrollable crying has not been documented before now.

To further highlight this, the case of a 4-month-old boy who presented with inconsolable crying following a flea bite is reported. The child had apparently enjoyed good health, however, presented with excessive crying lasting for 3 h which the parents could not determine the cause. There was not any history of fever, or trauma and a review of the systems were not remarkable; however on a thorough physical examination, a tiny insect glued to the right inguinal fold was noted; upon removal it was found to be engorged with blood and multiple bite marks were observed; he was placed on analgesic, the child got relieved and was discharged 1 h later. This insect was adjudged to be a flea-since there were pets in their home. Fleas are wingless insects which parasitize humans and animals for the required bloodmeal essential for their reproduction. They are skilled in biting and multiple bites can be generated by a single flea. These are often irritating, itchy and painful, resulting in red marks which may be confused with mosquito bite marks. Therefore, the healthcare of our pets is also vital to our well-being because some diseases are zoonotic to humans.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Zeskind PS, Klein L, Marshall TR. Adults perception of experimental modifications of durations of pauses and expiratory sounds in infant crying. Dev Psychol 1992;28:1153-62.  Back to cited text no. 1
    
2.
Brazelton TB. Application of cry research to clinical perspectives. In: Lester BM, Boukydis CF, editors. Infant Crying: Theoretical and Research Perspectives. New York: Plenum Press; 1985. p. 12-9.  Back to cited text no. 2
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3.
Reijneveld SA, Brugman E, Hirasing RA. Excessive infant crying: The impact of varying definitions. Pediatrics 2001;108:893-7.  Back to cited text no. 3
[PUBMED]    
4.
Radesky JS, Zuckerman B, Silverstein M, Rivara FP, Barr M, Taylor JA, et al. Inconsolable Infant Crying and Maternal Postpartum Depressive Symptoms Pediatrics. Available from: http://www.pediatrics.aappublications.org/concent/early/2013/04/30/peds. 2012-3316.full.pdf. [Last assessed on 2016 Apr 30].  Back to cited text no. 4
    
5.
Fuller BF. Acoustic discrimination of three types of infant cries. Nurs Res 1991;40:156-60.  Back to cited text no. 5
[PUBMED]    
6.
The Royal Children's Hospital Melbourne. Insect Bites and Stings. Available from: https://www.rch.org.au/kidsinfo/fact_sheets/Insect_bites_and_stings/. [Last assessed on 2017 Apr 10].  Back to cited text no. 6
    




 

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